Facing Breast Cancer During Pregnancy

Medical Video: Breast Cancer Discovered During Pregnancy

Breast cancer during pregnancy is a very rare case. But now, more and more women are choosing to delay pregnancy even though the risk of breast cancer is higher when women get older. Therefore, doctors estimate that there will be an increase in breast cancer cases during pregnancy in the future.

Detect breast cancer during pregnancy

Pregnant women who have breast cancer are more often diagnosed with advanced cancer than non-pregnant women. Cancer may have spread to lymph nodes, and this is triggered by hormonal changes during pregnancy. Pregnancy automatically stops the monthly menstrual cycle so that estrogen and progesterone levels rise. Prolactin, a hormone for breastfeeding, also rises during pregnancy. These hormonal changes usually change the shape of the breasts to become bigger, swollen and supple. These breast changes make it difficult for doctors to detect a cancerous lump until the size of the cancer becomes quite large.

Another reason for the difficulty of detecting breast cancer early during pregnancy is the delay in screening tests until the pregnancy ends. Delayed diagnosis is one of the biggest problems in dealing with breast cancer in pregnancy. Pregnancy and breastfeeding can also make breast tissue denser, making it more difficult to detect cancer early on a mammogram. In addition, the initial symptoms caused by cancer are often mistaken for normal changes that usually occur during pregnancy.

Don't underestimate your breast lumps or changes. If the doctor does not recommend tests such as mammograms, ask about other types of imaging tests such as ultrasound or MRI. In dealing with a situation like this, you might need to look for opinions from two doctors. In essence, any change in suspicious breasts must be examined or even biopsied before it is assumed to be a normal response during pregnancy.

Mammograms can detect breast cancer that appears when a woman is pregnant. This test is quite safe to use during pregnancy. In addition to the relatively small amounts, radiation mammograms are only focused on the breast so that they do not hit other body parts. For extra protection, a protector will be placed in the lower part of the stomach to stop radiation from reaching the uterus. However, scientists have not been able to ascertain the effects of radiation (even in very small amounts) for unborn babies.

Even during pregnancy, early detection is an important part of breast health. Talk to your doctor or nurse about breast examination and the best time for the next mammogram. Always remember! If you find a lump or change in your breasts, contact your doctor immediately.

Diagnosis of breast cancer during pregnancy

Lumps or abnormal imaging test results can certainly cause concern. Therefore, a biopsy must be done to make sure the breast changes are cancer or not. During a biopsy, a piece of tissue will be taken from the area suspected of containing cancer cells. Breast biopsy is most often done using a needle. Usually, biopsies are performed as an outpatient procedure (even for pregnant women). The doctor will give medication for numbness only in the breast area involved in the biopsy. The risk of this process in the fetus is small.

If the results of a needle biopsy have not provided an answer, a surgical biopsy is the next step. A surgical biopsy will remove a piece of tissue through a small wound (incision) in the breast. In general, this process is carried out under general anesthesia (anesthesia) and a small risk for the fetus remains.

Test to determine the stage of breast cancer

If breast cancer has been found, other tests will be needed to determine the spread of cancer cells in the breast or other body parts. This process is called stadium. Stadium is very important for pregnant women with breast cancer because cancer tends to be found in a more advanced stage (the tumor size is larger and has spread beyond the breast). Staging tests that may be needed depend on your case.

Keep in mind that tests such as ultrasound and magnetic resonance imaging (MRI) do not expose radiation to the fetus. Overall, this test is considered safe and can be used for your treatment. However, contrast ink (dye) sometimes used in MRI through the placenta, an organ that connects mother to fetus. Through animal test joba in the laboratory, contrast ink has been linked to the risk of abnormalities in the fetus. For this reason, MRI with contrast dye is not recommended during pregnancy. Instead, MRI without contrast can be used if needed.

Chest X-rays are sometimes needed in making treatment decisions. Because using small amounts of radiation, chest X-rays are safe for pregnant women, especially when the abdomen is protected.

Other tests, such as PET scans, bone scans, and computed tomography (CT) scans are more risky for the fetus to be exposed to radiation. This test is usually not needed, especially if the cancer only attacks the breast. If the test has to be done, the doctor may be able to limit the amount of radiation exposure to the fetus.

In very rare cases, cancer has reached the placenta (the organ that connects the mother to the fetus). This can affect the amount of nutrients the fetus receives from the mother. But so far, there have been no reports of breast cancer cases that are transmitted from mother to fetus.

Treatment of breast cancer during pregnancy

Recommendations for cancer treatment during pregnancy will depend on several aspects, such as:

Tumor size
Location of tumor
Cancer spread
Womb age
Patient choice

Basically, breast cancer treatment for pregnant women has the same goal as cancer treatment for a woman who is not pregnant, namely controlling and preventing the spread of cancer. Treatment for pregnant women may be more complex because it requires extra attention in protecting the fetus.

Breast cancer surgery is generally safe during pregnancy. Other treatments, such as chemotherapy, hormone therapy, targeted therapy, and radiation therapy can harm the fetus if given during pregnancy. Unsafe chemotherapy is given during early pregnancy. If the patient has breast cancer at the beginning of pregnancy and requires immediate chemotherapy, the doctor will provide an option to terminate the pregnancy. Some types of breast cancer (such as inflammatory breast cancer) and delay in treatment are likely to endanger patients.

Previous research has said that ending a pregnancy due to cancer treatment will not increase the chances of recovery. Although this study is not perfect, ending pregnancy is rarely done if breast cancer is found. However, this choice may be discussed further after looking at all available treatment options, especially in aggressive cancers that may require immediate treatment. Patients and families need to understand the risks and benefits of all treatment options before making a decision.

READ ALSO: